Special Report

The Least Healthy County in Every State

Source: Public Domain / Wikimedia Commons

36. Oklahoma
> Least healthy county: Adair
> Population without health insurance 22.6%
> Population with limited access to healthy food 18.5%
> Obesity rate: 41.9%

Nearly 42% of adults in Adair County are obese, the largest share of any county in Oklahoma and one of the largest shares of any U.S. county. Poorer populations are often at an elevated risk of obesity as unhealthy, calorie-heavy foods are often less expensive than healthier fresh fruits and vegetables and lean meats. In Adair County, slightly more than 30% of the population lives in poverty, well above the state and U.S. poverty rates of 16.5% and 15.1%, respectively. Obesity can take a daily toll on physical and mental health, and adults in Adair County report an average of 5.9 physically unhealthy days and 5.8 mentally unhealthy days per month, each the most of any county in the state.

Source: Finetooth / Wikimedia Commons

37. Oregon
> Least healthy county: Jefferson
> Population without health insurance 12.7%
> Population with limited access to healthy food 13.7%
> Obesity rate: 35.2%

Americans with health insurance are typically in better health than the uninsured as they are more likely to schedule regular doctor visits and receive preventative care and treatment. In Jefferson County, the least healthy county in Oregon, 12.7% of the population lacks health insurance, the largest share of any county in the state. Likely partially due to the high uninsured rate, premature, largely preventable death is far more common in Jefferson County than it is across the state as a whole.

Most Americans receive health insurance through their employers, but in Jefferson, 6.7% of workers are out of a job, well above the 4.9% state and national unemployment rates. Improved economic conditions would likely increase health insurance coverage rates and lead to better health outcomes across the county population.

Source: Thinkstock

38. Pennsylvania
> Least healthy county: Philadelphia
> Population without health insurance 11.0%
> Population with limited access to healthy food 21.0%
> Obesity rate: 29.4%

Seated by, and coterminous with the city of Philadelphia, Philadelphia County is the least healthy county in Pennsylvania. Several unhealthy habits are relatively common among Philadelphia residents. For example, 22.1% of adults in the county drink excessively on a regular basis, higher than the excessive drinking rate statewide of 20.5% and nationwide of 18.0%. Additionally, despite nearly every Philadelphia resident having access to places for physical activities like gyms and parks, adults in the county are less likely to have active lifestyles than the typical adult in Pennsylvania.

Source: Thinkstock

39. Rhode Island
> Least healthy county: Providence
> Population without health insurance 8.0%
> Population with limited access to healthy food 13.5%
> Obesity rate: 28.1%

Rhode Island is a relatively healthy state, and even in Providence, the least healthy county in the state, outcomes are not much worse than they are nationwide. For example, 16.5% of adults in Providence County are in fair or poor health, more than the 14.8% of adults across the state but only slightly higher than the 16.0% share nationwide. Similarly, 28.1% of county adults are obese, compared to 28.0% of adults nationwide and 27.2% of adults across Rhode Island. Adults in Providence County are also only slightly less likely to lead physically active lives than those across both the state and the U.S. as a whole.

Source: Calvin Beale / Public Domain / Wikimedia Commons

40. South Carolina
> Least healthy county: Marlboro
> Population without health insurance 14.4%
> Population with limited access to healthy food 23.2%
> Obesity rate: 36.6%

About one in every four adults in Marlboro County, South Carolina, are in fair or poor health, well above the respective 19.1% and 16.0% state and national shares. The area’s poor health outcomes are likely attributable in part to some unhealthy behaviors. For example, adults in Marlboro County are more likely to smoke and less likely to exercise regularly than the typical American or South Carolinian adult. Physical inactivity rates in the county would likely improve with greater access to venues for physical activity. Virtually no residents of the county along the state’s northern border have access to places for exercise like gyms and parks.

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